体外受精周期中空卵泡综合征3例报道及文献复习

目的：探讨体外受精（in vitro fertilization，IVF）周期中空卵泡综合征（empty follicle syndrome，EFS）发生的原因及应对策略。方法：分析3例EFS患者的临床资料，并复习文献。结果：2例因EFS取消周期，在随后的周期中，虽未再次发生EFS但结局均不满意，其中1例因卵巢储备功能下降仅获1枚Ⅲ级胚胎，另1例2个周期共获14枚卵，其中11枚为GV期卵。第3例患者一侧卵巢取卵出现EFS，第二次注射人绒毛膜促性腺激素（hCG）补救，24h再次取卵，部分卵泡已排出，获2枚MⅡ卵及2枚胚胎，因出现卵巢过度刺激综合征取消移植。结论：EFS可能与hCG药物及卵巢功能紊乱有关；再次注射hCG补救对挽救周期有效，但更应注重预防及个体化补救措施。

Empty follicle syndrome in in vitro fertilization cycles:a report of 3 cases and review of the literature

Objective：To explore the causes and coping strategies for empty follicle syndrome （EFS） in vitro fertilization （IVF） cycles. Methods：The clinical data of 3 patients with EFS were analyzed, and the literature was reviewed. Results：The cycles in 2 patients were cancelled due to of EFS; in the succedent cycles, EFS did not occur, but the outcome was not satisfactory ; one of them got only 1 embryo （ Ⅲ grade） due to descend of ovary reserve function, and the other got 14 oocytes including 11 G V oocytes in two cycles. The third patient had EFS at one side ovary, and a second dose of hCG was injected and a second retrieval was scheduled after 24 hours;some follicles had ruptured before the second retrieval,2 oocytes were retrieved and 2 embryos were obtained; transplantation was cancelled due to ovarian hyperstimulation syndrome. Conclusions： EFS may be associated with hCG drug and ovarian dysfunction. Rescue by injecting hCG is effective, but more emphasis should be put on prevention and individual measures.